Getting better

Supporting employees through mental health leaves

Getting better
Awareness and treatment alternatives are helping to reduce the stigma of mental health challenges for employees. Credit: Lightspring (Shutterstock)

Employers are increasingly facing the challenge of managing mental health absences from the workplace. Like all employee absences, there are complex legal and operational implications for employers, but mental health issues can also bring social, communication and team challenges that need to be addressed respectfully, compassionately and with a commitment to confidentiality.

Fortunately, awareness and treatment alternatives are helping to reduce the stigma of mental health challenges for employees. Many employers have begun to adjust their practices to ensure there are supports in place for employees dealing with mental health challenges.

Similar to time off for an illness, a mental health leave should see the employee working with her treatment teams, while the employer has the opportunity to prepare operations to reintegrate the individual back into the workplace. This means protecting confidentiality, managing contact effectively, and supporting the employee in coming back to her job.

Protecting confidentiality

Protecting an absent employee’s confidentiality is both a legal and moral responsibility, regardless of the nature of the absence. For employers, a particularly challenging aspect of managing a mental health-related absence is in addressing natural concerns and curiosity about the absenteeism, especially if symptoms are less obvious than a physical health issue.

As a rule, employers should provide as little information as possible to other employees regarding a colleague’s absence and subsequent return to work. Updates that need to be shared should focus on operational requirements, rather than the employee’s medical situation.

For example, an update should focus on when the employee will be back at work and his specific roles and responsibilities. An approach like “Jane will be at work for three days a week for the next two weeks, and will resume a five-day-a-week schedule within a month” is far better than “Jane can’t handle a full workweek right now because she has been ill.”

Keeping in touch

The direct manager and person responsible for managing the absence (typically HR) are the best people to contact the absent employee. Communication from the manager should focus on showing concern for the employee’s well-being, expressing support around his return to work, and providing general updates about the workplace. Contact from HR can deal with the availability of and access to benefits, the requirements to substantiate an absence or return to work, and other employment-related concerns.

Ideally, contact with both managers and human resources teams should be co-ordinated. This ensures cohesiveness and will avoid people inadvertently giving different impressions about expectations and outcomes during the absence.

It is important for employers to ensure they do not appear to unduly rush the employee with a return-to-work plan, and instead show that a commitment to an improvement in the person’s health and wellness is the priority. The method of contact will depend on the relationship between the employee and her manager. Exchanging emails is ideal for conveying crucial information and can be less intrusive than phone or in-person contact, but it can lack the warmth and human connection of a conversation, and can also be misunderstood.

When in contact with the absent employee, the employer should not ask specific questions about her medical condition. Employees may volunteer this information, but it is not needed for responsible return-to-work planning. Employers should exercise caution when requesting information, and if unsure about what information can reasonably or legally be requested, consulting an employment lawyer is advised.

Followup timelines should be developed on a case-by-case basis, with contact between the employer and employee occurring at least once a month. Establishing these as routines with an absent employee helps that person feel supported and connected.

Return-to-work support

Re-integration should be specific to an employee’s return-to-work plan. The direct manager’s role is vital as he has the clearest picture of the employee’s day-to-day responsibilities, her performance and medical situation.

One-on-one conversations between the employee and manager should occur regularly, beginning with a brief introductory meeting on the first day of the employee’s return to work, followed by a check-in at the end of that day, another meeting at the end of the first week, and weekly thereafter.

The focus of these conversations should be on how the employee is managing during this initial period back, how she is performing her duties, and whether the employee clearly understands the expectations as she returns to her job.

There are additional practices that may ease an employee’s return to work and help set him up for success. By making his first day back a Friday, it allows the returning employee to move directly into a weekend, relieving pressure and giving the person a longer opportunity to reorient himself to employment routines.

Similarly, re-establishing important personal and professional relationships between the person returning and his peers at a low-key team meal puts the emphasis on support and recovery, and avoids a “get-to-work” tone.

Supervisors, managers and human resources teams may not be trained or naturally prepared to manage a return-to-work situation. They may not know what to say to the person because mental health leaves can carry misunderstanding and stigma.

Organizations would do well to provide support to the team to ensure both employee and employer success. This includes training leaders on how to avoid requesting too much information from the returning employee or providing too much information to others. By focusing communication on roles and responsibilities, rather than limitations, managers are less likely to overshare or over-explain. Team communication should focus on an employee’s responsibilities now that she’s back at work, rather than why she was absent.

As an employee begins to perform her duties, modified or otherwise, managers should watch closely but unobtrusively for performance indicators that signal struggles or success with the return-to-work plan. Managers should avoid speculation or diagnosis; instead, their observations should be limited to the roles and responsibilities laid out in the plan.

Some challenges will be obvious, and major red flags such as unexplained absenteeism or failure to perform basic tasks should prompt immediate conversations between the manager and employee — always in a non-adversarial and professional manner. As an outcome of these conversations, employers should consider modifying the plan to better meet the employee’s needs.

Performance is possible

Organizations should ensure they are not withholding opportunities from the employee because of bias or past history, both for the employee’s sake and for the good of the organization. Employees returning from a mental health-related absence can perform at a high level, and employers should avoid the assumption that a mental health issue permanently impacts the person’s ability to cope with stress or advance his career.

Many people who have sought treatment for mental health issues may have improved coping skills because they have learned to manage stressful challenges through therapy and recovery.

There remains a significant lack of understanding about mental health issues. It is worthwhile for employers, as they acknowledge the diversity of abilities and competencies that define all workplaces, to remember that this includes those who are dealing, or have dealt, with a mental health issue. While the employee may be limited in one context, this doesn’t mean he is limited in all.

At the same time, symptoms may reoccur or increase if the employee feels she is being stigmatized for her condition. Violations of confidentiality, subtle discrimination or social tension can lead to poor employment performance or even relapse. It is in everyone’s best interest — the employee for her recovery and the employer for organizational performance — to look beyond a return-to-work plan towards career development and growth.

Professionals need professionals

Fortunately, employers aren’t alone in working through the complex challenges of mental health leaves. By working with treatment teams and disability management professionals, employers can help to create plans, strategies and situations that allow employees to return to work and open up avenues for improved performance.

Working together with employers, these resources can move employers past integration to a place where employees suffering from mental health challenges are supported, engaged and empowered.

Matt Hendrick is the Vancouver-based president of the Disability Management Institute. For more information, visit

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